Non-AIDS defining cancers in the D:A:D Study - time trends and predictors of survival: A cohort study

Signe W. Worm, Mark Bower, Peter Reiss, Fabrice Bonnet, Matthew Law, Gerd Fätkenheuer, Antonella d'Arminio Monforte, Donald I. Abrams, Andrew Grulich, Eric Fontas, Ole Kirk, Hansjakob Furrer, Stephane D. Wit, Andrew Phillips, Jens D. Lundgren, Caroline A. Sabin, D. Butcher, M. Delforge, I. Fanti, X. FranquetS. Geffard, L. Gras, J. Helweg-Larsen, M. Hillebregt, D. Kamara, J. Kjær, E. Krum, H. McManus, P. Meidahl, A. Mocroft, J. Nielsen, W. Powderl, M. Rickenbach, R. Rode, L. Ryom, R. Salbøl Brandt, J. Schmidt Iversen, N. Shortman, A. Sjøl, C. Smith, F. Torres, J. Tverland, S. Wright, S. Zaheri, F. de Wolf, J. Smidt, M. Ristola, C. Katlama, J. P. Viard, P. M. Girard, J. M. Livrozet, P. Vanhems, C. Pradier, F. Dabis, D. Neau, J. Rockstroh, R. Schmidt, O. Degen, J. van Lunzen, H. J. Stellbrink, S. Staszewski, J. Bogner, P. Gargalianos, J. Kosmidis, J. Perdios, G. Xylomenos, A. Filandras, E. Karabatsaki, G. Panos, H. Sambatakou, D. Banhegyi, F. Mulcahy, M. Burke, D. Turner, I. Yust, G. Hassoun, S. Pollack, S. Maayan, S. Vella, R. Esposito, I. Mazeu, C. Mussini, C. Arici, R. Pristera, A. Gabbuti, F. Mazzotta, M. Lichtner, V. Vullo, K. Boer, S. E. Geerlings, M. H. Godfried, T. W. Kuijpers, J. M.A. Lange, F. J.B. Nellen, D. Pajkrt, J. M. Prins, H. J. Scherpbier, S. M.E. Vrouenraets, F. W.M.N. Wit, M. van Vugt, J. T.M. van der Meer, T. van der Poll, M. van der Valk, A. Chirianni, M. Gargiulo, E. Montesarchio, G. Antonucci, P. Narciso, A. Testa, C. Vlassi, M. Zaccarelli, A. Castagna, N. Gianotti, A. Lazzarin, M. Galli, A. Ridolfo, B. Rozentale, I. Zeltina, S. Chaplinskas, R. Hemmer, T. Staub, J. Bruun, A. Maeland, V. Ormaasen, S. Lowe, A. Oude Lashof, G. Schreij, J. Gasiorowski, B. Knysz, E. Bakowska, A. Horban, R. Flisiak, A. Grzeszczuk, A. Boron-Kaczmarska, M. Parczewski, M. Pynka, M. Beniowski, E. Mularska, H. Trocha, E. Jablonowska, E. Malolepsza, K. Wojcik, F. Antunes, L. Caldeira, M. Doroana, K. Mansinho, F. Maltez, B. Bravenboer, M. J.H. Pronk, D. Duiculescu, A. Rakhmanova, N. Zakharova, S. Buzunova, D. Jevtovic, M. Mokráš, D. Staneková, J. Tomazic, J. González-Lahoz, P. Labarga, J. Medrano, V. Soriano, S. Moreno, J. M. Rodriguez, I. Bravo, B. Clotet, A. Jou, R. Paredes, J. Puig, C. Tural, L. B.S. Gelinck, J. L. Nouwen, B. J.A. Rijnders, C. A.M. Schurink, L. Slobbe, A. Verbon, T. E.M.S. de Vries-Sluijs, M. E. van der Ende, M. van der Feltz, J. M. Gatell, J. M. Miró, P. Domingo, M. Gutierrez, G. Mateo, M. A. Sambeat, A. Karlsson, L. Flamholc, B. Ledergerber, R. Weber, M. Cavassini, P. Francioli, E. Boffi, B. Hirschel, M. Battegay, L. Elzi, N. Chentsova, E. Kravchenko, G. J.A. Driessen, N. G. Hartwig, V. Frolov, G. Kutsyna, S. Servitskiy, M. Krasnov, S. Barton, A. M. Johnson, D. Mercey, M. A. Johnson, M. Murphy, G. Scullard, M. Fisher, C. Leen, J. Branger, B. Åkerlund, L. Morfeldt, A. Sundström., G. Thulin, K. Koppel, C. Ho̊kangård, G. Angarano, A. Antinori, O. Armignacco, F. Castelli, R. Cauda, G. Di Perri, R. Iardino, G. Ippolito, M. Moroni, C. F. Perno, P. L. Viale, F. Von Schlosser, A. Ammassari, M. Andreoni, C. Balotta, P. Bonfanti, S. Bonora, M. Borderi, M. R. Capobianchi, F. Ceccherini-Silberstein, P. Cinque, A. Cozzi-Lepri, A. De Luca, C. Gervasoni, E. Girardi, A. Gori, G. Guaraldi, S. Lo Caputo, G. Madeddu, F. Maggiolo, G. Marchetti, S. Marcotullio, L. Monno, R. Murri, M. Puoti, C. Torti, P. Cicconi, T. Formenti, L. Galli, P. Lorenzini, A. Costantini, A. Giacometti, A. Riva, C. Carrisa, G. Lazzari, G. Verucchi, E. F. Schippers, C. Minardi, C. Abeli, T. Quirino, P. E. Manconi, P. Piano, K. Falasca, J. Vecchiet, D. Segala, L. Sighinolfi, A. Alessandrini, G. Cassola, G. Mazzarello, R. Piscopo, G. Viscoli, V. Belvisi, C. Mastroianni, I. Caramma, P. Castelli, A. Chiodera, M. A. Alleman, J. W. Bouwhuis, P. H.P. Groeneveld, A. Bigoloni, L. Carenzi, A. Galli, M. C. Moioli, R. Piolini, A. L. Ridolfo, G. Rizzardini, R. Rossotti, S. Salpietro, V. Spagnuolo, P. Zucchi, L. Bisio, G. Lapadula, N. Abrescia, M. G. Guida, F. Baldelli, B. Belfiori, G. Parruti, T. Ursini, G. Magnani, M. A. Ursitti, R. Acinapura, M. Capozzi, L. Gallo, R. Libertone, E. Nicastro, G. Tebano, V. Tozzi, A. d'Avino, M. S. Mura, P. Caramello, G. C. Orofino, M. Sciandra, R. Soetekouw, R. W. ten Kate, V. Manfrin, G. Pellizzer, E. Bernard, C. Caissotti, E. Cua, F. De Salvador-Guillouet, P. Dellamonica, K. Dollet, J. Durant, S. Ferrando, V. Mondain-Miton, A. Naqvi, I. Perbost, S. Pillet, B. Prouvost-Keller, P. Pugliese, V. Rahelinirina, P. M. Roger, J. Barth, E. Bernasconi, J. Böni, H. C. Bucher, C. Burton-Jeangros, A. Calmy, C. Cellerai, R. Dubs, M. Egger, J. Fehr, M. Flepp, C. A. Fux, M. Gorgievski, H. Günthard, B. Hasse, H. H. Hirsch, I. Hösli, C. Kahlert, L. Kaiser, O. Keiser, C. Kind, T. Klimkait, H. Kovari, G. Martinetti, B. Martinez de Tejada, N. Müller, D. Nadal, G. Pantaleo, A. Rauch, S. Regenass, C. Rudin, P. Schmid, F. Schöni-Affolter, J. Schüpbach, D. Schultze, R. Speck, P. Taffé, A. Telenti, A. Trkola, P. Vernazza, S. Yerly, V. von Wyl, S. M. Arend, H. Jolink, F. P. Kroon, M. G.J. de Boer, J. T. van Dissel, C. van Nieuwkoop, P. J. van den Broek, K. Pogany, J. G. den Hollander, W. Kortmann, G. van Twillert, E. M.S. Leyten, R. Vriesendorp, G. J. Kootstra, C. H.H. ten Napel, W. L. Blok, K. Brinkman, P. H.J. Frissen, W. E.M. Schouten, G. E.L. van den Berk, A. E. Brouwer, J. R. Juttmann, M. E.E. van Kasteren, K. D. Lettinga, J. Veenstra, J. W. Mulder, P. M. Smit, S. Weijer, E. C.M. van Gorp, D. W.M. Verhagen, A. van Eeden, R. Doedens, E. H. Scholvinck, H. G. Sprenger, C. J. Stek, S. van Assen, A. M. Brouwer, A. S.M. Dofferhoff, M. Keuter, P. P. Koopmans, R. de Groot, H. J.M. ter Hofstede, M. van der Flier, A. J.A.M. van der Ven, J. E. Arends, P. M. Ellerbroek, A. I.M. Hoepelman, C. A.J.J. Jaspers, L. J. Maarschalk-Ellerbroek, T. Mudrikova, J. J. Oosterheert, E. J.G. Peters, M. M.E. Schneider, M. W.M. Wassenberg, J. C.H. van der Hilst, W. F.W. Bierman, F. A.P. Claessen, S. A. Danner, R. M. Perenboom, E. A. bij de Vaate, E. V. de Jong, J. de Vocht, M. A. van Agtmael, S. P.M. Geelen, T. F.W. Wolfs, E. H. Gisolf, J. P. Richter, C. van der Berg, A. Stegeman, M. van den Berge, M. B. Polée, D. P.F. van Houte, M. G.A. van Vonderen, A. J. Duits, C. Winkel, G. Chêne, M. Dupon, H. Fleury, D. Lacoste, D. Malvy, P. Mercié, P. Morlat, I. Pellegrin, J. L. Pellegrin, R. Thiébaut, K. Titier, M. Bruyand, S. Lawson-Ayayi, L. Wittkop, N. Bernard, F. Bonnal, L. Caunègre, C. Cazanave, J. Ceccaldi, D. Chambon, I. Chossat, K. Courtaud, F. A. Dauchy, S. De Witte, P. Duffau, A. Dupont, H. Dutronc, S. Farbos, V. Gaboriau, M. C. Gemain, Y. Gerard, C. Greib, M. Hessamfar, S. Lafarie-Castet, P. Lataste, E. Lazaro, M. Longy-Boursier, J. P. Meraud, E. Monlun, A. Ochoa, T. Pistone, J. M. Ragnaud, M. C. Receveur, J. Roger-Schmeltz, S. Tchamgoué, P. Thibaut, M. A. Vandenhende, J. F. Viallard, J. F. Moreau, I. Pellegrin., M. E. Lafon, B. Masquelier, P. Trimoulet, D. Breilh, F. Haramburu, G. Miremont-Salamé, M. J. Blaizeau, C. D'Ivernois, M. Decoin, J. Delaune, S. Delveaux, C. Hanappier, O. Leleux, X. Sicard, B. Uwamaliya-Nziyumvira, J. Leray, G. Palmer, D. Touchard, D. Baker, C. Bendall, M. Bloch, A. Carr, D. Cooper, T. Franic, K. Petoumenos, R. Vale, S. Edwards, J. Hoy, R. Moore, J. Nicholson, N. Roth, K. Watson, J. Chuah, M. Ngieng, D. Nolan, J. Skett, J. Cadafalch, G. Calvo, C. Codina, E. Del Cacho, M. Fuster, J. Gatell, S. Mateu, G. Sirera, A. Vaqué, N. Clumeck, S. De Wit, A. F. Gennotte, M. Gerard, K. Kabeya, D. Konopnicki, A. Libois, C. Martin, C. Necsoi, M. C. Payen, P. Semaille, Y. Van Laethem, G. Bartsch, W. M. El-Sadr, J. Neaton, G. Thompson, D. Wentworth, R. Luskin-Hawk, E. Telzak, D. Cohn, N. Markowitz, R. Arduino, D. Mushatt, G. Friedland, G. Perez, E. Tedaldi, E. Fisher, F. Gordin, L. R. Crane, J. Sampson, J. Baxter, A. H. Fischer, D. Grint, J. Kjaer, J. Kowalska, L. Peters, D. Podlekareva, J. Reekie, C. Elias, M. Losso, N. Vetter, R. Zangerle, I. Karpov, A. Vassilenko, V. M. Mitsura, O. Suetnov, R. Colebunders, L. Vandekerckhove, V. Hadziosmanovic, K. Kostov, J. Begovac, D. Jilich, L. Machala, D. Sedlacek, T. Benfield, G. Kronborg, M. Larsen, J. Gerstoft, A. B.E. Hansen, T. Katzenstein, P. Skinhøj, C. Pedersen, L. Ostergaard, K. Zilmer

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Abstract

Background: Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.Methods: Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.Results: Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.Conclusions: The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC.

Original languageEnglish
Article number471
JournalBMC Infectious Diseases
Volume13
Issue number1
DOIs
Publication statusPublished - Oct 9 2013

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Keywords

  • HIV
  • Incidence
  • Non-AIDS defining cancers
  • Prognosis
  • Trends

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Worm, S. W., Bower, M., Reiss, P., Bonnet, F., Law, M., Fätkenheuer, G., d'Arminio Monforte, A., Abrams, D. I., Grulich, A., Fontas, E., Kirk, O., Furrer, H., Wit, S. D., Phillips, A., Lundgren, J. D., Sabin, C. A., Butcher, D., Delforge, M., Fanti, I., ... Zilmer, K. (2013). Non-AIDS defining cancers in the D:A:D Study - time trends and predictors of survival: A cohort study. BMC Infectious Diseases, 13(1), [471]. https://doi.org/10.1186/1471-2334-13-471